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Assessing Health Care Organizations’ Ability to Implement Screening, Brief Intervention, and Referral to Treatment

Bohman, Thomas M. PhD; Kulkarni, Shanti PhD; Waters, Vicki MS, PA-C; Spence, Richard T. PhD; Murphy-Smith, Michele PhD; McQueen, Katherine MD

doi: 10.1097/ADM.0b013e3181800ae5
Original Article

Objectives: To determine if a new measure of organizational readiness for change reflects site and staff role differences when implementing a screening, brief intervention, and referral to treatment (SBIRT) program for alcohol and drug misuse in a healthcare organization.

Sample: One hundred forty-one Community Health Program (CHP) and 45 Emergency Center (EC) respondents completed the survey.

Methods: Medical and ancillary staff from a Level 1 trauma hospital EC and 3 CHP clinics within a large, urban, publicly funded health-care system were asked to complete the 45-item Medical Organizational Readiness for Change (MORC) survey 5 to 7 months after the start of implementation planning. One-way ANOVAs compared the 4 sites’ responses and independent t tests compared the clinical versus administrative staff responses on 8 MORC scales.

Results: There were statistically significant differences between the EC and CHP sites on Need for External Guidance, Pressure to Change, Organizational Readiness to Change, Workgroup Functioning, Work Environment, and Autonomy Support. Clinical and administrative staff differed significantly on Need for External Guidance, Pressure to Change, and Organizational Readiness to Change. When change agents used the MORC data to inform their implementation process, the results were positive.

Conclusions: Among CHP sites, there were differences in organizational functioning, which were consistent with CHP implementation outcomes. The MORC scales can help planners and change agents understand their organization’s current readiness to integrate screening, brief intervention, and referral to treatment services into their medical setting.

From Addiction Research Institute (TMB, RTS, MM-S), School of Social Work, University of Texas at Austin, Austin; Department of Internal Medicine (KM) and School of Allied Health Sciences (VW), Baylor College of Medicine, Houston, Texas; and Department of Social Work (SK), College of Health and Human Services, University of North Carolina—Charlotte, Charlotte, North Carolina.

Received October 10, 2007; accepted May 15, 2008.

Send correspondence and reprint requests to Thomas M. Bohman, PhD, Addiction Research Institute/GCATTC, Center for Social Work Research, University of Texas at Austin, 1717 West 6th Street, Suite 335, Austin, TX 78703. e-mail:

The views and opinions contained in the publication do not necessarily reflect those of SAMHSA or the US Department of Health and Human Services, and should not be construed as such.

© 2008 American Society of Addiction Medicine